Cannabinoid Content and Label Accuracy of Hemp-Derived Topical Products Available Online and at National Retail Stores
Authors: Tory R. Spindle, Dennis J. Sholler, Edward J. Cone, Timothy P. Murphy, Mahmoud ElSohly, Ruth E. Winecker, Ronald R. Flegel, Marcel O. Bonn-Miller, Ryan Vandrey
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Products containing cannabinoids such as cannabidiol (CBD) have proliferated since 2018, when the Agriculture Improvement Act removed hemp (ie, cannabis containing &lt;0.3% Δ<sup>9</sup>-tetrahydrocannabinol [THC]) from the US controlled substances list. Topical cannabinoid products can be purchased nationwide at retail stores and over the internet, yet research on these products is scarce. <h3>Objective</h3> To evaluate the cannabinoid content (ie, CBD and THC) and label accuracy of topical cannabinoid products and to quantify their therapeutic and nontherapeutic claims. <h3>Design, Setting, and Participants</h3> Product inclusion criteria included designation as hemp products, intended for topical or transdermal application, and purported to contain cannabinoids (eg, CBD). All unique products available at each retail store were purchased. Online products were identified via Google using relevant keywords (eg, hemp or CBD topical). Various products (eg, lotions and patches) were purchased from retail stores (eg, pharmacies, grocery stores, and cosmetic or beauty stores) in Baltimore, Maryland, and online. Data analysis was performed from March to June 2022. <h3>Main Outcomes and Measures</h3> Labeled and actual total amounts of CBD and THC, measured via gas chromatography–mass spectrometry. Therapeutic and nontherapeutic claims and references to the US Food and Drug Administration were quantified. <h3>Results</h3> A total of 105 products were purchased, 45 from retail locations and 60 online. Of the 89 products that listed a total amount of CBD on the label, 18% (16 products) were overlabeled (ie, contained &gt;10% less CBD than advertised), 58% (52 products) were underlabeled (ie, contained &gt;10% more CBD than advertised), and 24% (21 products) were accurately labeled. The median (range) percentage deviation between the actual total amount of CBD and the labeled amount was 21% (−75% to 93%) for in-store products and 10% (−96% to 121%) for online products, indicating that products contained more CBD than advertised overall. THC was detected in 37 of 105 products (35%), although all contained less than 0.3% THC. Among the 37 THC-containing products, 4 (11%) were labeled as THC free, 14 (38%) indicated they contained less than 0.3% THC, and 19 (51%) did not reference THC on the label. Overall, 28% of products (29 products) made therapeutic claims, 14% (15 products) made cosmetic claims, and only 47% (49 products) noted that they were not Food and Drug Administration approved. <h3>Conclusions and Relevance</h3> In a case series of topical cannabinoid products purchased online and at popular retail stores, products were often inaccurately labeled for CBD and many contained THC. These findings suggest that clinical studies are needed to determine whether topical cannabinoid products with THC can produce psychoactive effects or positive drug tests for cannabis.